Efficacy and safety analysis of atezolizumab continuation beyond progression in extensive-stage small cell lung cancer

作者：Wenhao Shi, Xiaohui Bao, Jin Xiong, Yanqiao Wu, Jianguo Sun, Zhixiang Xu, Dairong Li, Wei Yang, Jun Ge, Biyong Ren, Jiang Yu, Kaijin Wang, Yu‐Sheng Huang, Yang Zhen-zhou, Yuan Peng · 发表于：Clinical and Experimental Medicine · 年份：2025 · DOI：10.1007/s10238-025-01606-1 · 被引用次数：5 · 研究领域：Lung Cancer Research Studies、Lung Cancer Treatments and Mutations、Peptidase Inhibition and Analysis

The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment landscape for extensive-stage small cell lung cancer (ES-SCLC) patients. However, many patients eventually develop resistance to immunotherapy. While continued ICI therapy beyond disease progression has shown survival benefits in various cancers, research specific to ES-SCLC remains limited. Our study aimed to further evaluate the efficacy and safety of atezolizumab continuation therapy to optimize the ICI continuation strategies for ES-SCLC. In this multicenter study, all enrolled patients received continued atezolizumab in combination therapy as second-line (2L) treatment after progression of first-line (1L) chemo-immunotherapy. The efficacy was measured by median overall survival (mOS) and median progression-free survival (mPFS). Safety was evaluated based on incidence of adverse events (AEs). Among the 28 eligible patients in this study, mPFS was 4.07 months [95% CI: 1.15 to 6.98], and mOS was 18.87 months [95% CI: 15.28 to 22.45]. In the safety analysis, respiratory-related AEs were the most common, including cough (35.7%), dyspnea (35.7%), pneumonitis (35.7%). Additionally, thyroiditis (17.9%) was the most generally reported immune-related adverse events (irAEs). In subgroup analysis, the LTR group (1L-PFS ≥ 6 months) showed longer mOS compared with the STR group (1L-PFS < 6 months) [19.98 vs. 8.68 months, p = 0.021]. Patients with greater DpR (≥ 29% than < 29%) had longer mOS: 21.84 vs. ...